Citation

Cnossen MC, van den Brande R, Lingsma H, Polinder S, Lecky F, Maas A. J. Neurotrauma 2018; ePub(ePub): ePub.

Affiliation

Netherlands ; Andrew.Maas@uza.be.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.5712

PMID

29732946

Abstract

The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is however not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the CENTER-TBI study. The survey was developed using literature review and expert opinion and was pilot-tested in 16 centers. All participants completed the questionnaire. Advanced life support was used in half of the centers (n=35, 52%), whereas the other centers used mainly basic life support (n = 26, 38%). A mobile medical team (MMT) could be dispatched 24/7 in most centers (n=66, 97%). Helicopters were used in approximately half of the centers to transport the MMT to the scene (n=39, 57%) and the patient to the hospital (n=31, 46%). Half of the centers used a stay-and-play approach at the scene (n=37, 55%) while the others used a scoop-and-run approach or another policy. We found wide variation in prehospital trauma care across Europe. This may reflect differences in socio-economic situations, geographic differences and may also reflect a general lack of strong evidence for some aspects of prehospital care. The current variation provides the opportunity to study the effectiveness of prehospital interventions and systems of care in comparative effectiveness research.

Language: en

Keywords

ADULT BRAIN INJURY; EPIDEMIOLOGY; TRAUMATIC BRAIN INJURY